Mondovi Dental of New Jersey - Bejarano PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MONDOVI DENTAL OF NEW JERSEY - BEJARANO PC

Practice address

513 Boulevard
Kenilworth, NJ 07033-1637

Phone

(908) 276-6652

Fax

(908) 709-4337

NPI assigned

Aug 7, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Diane Marie Brion-Martin

Title

Credentialing Supervisor

Phone

(715) 598-2311

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerome Scott Forman, D.M.D.

  • General Practice Dentistry
  • Kenilworth, NJ
  • NPI 1679650931
  NPD (past)
• Sakshi Sapru

  • General Practice Dentistry
  • Bridgewater, NJ
  • NPI 1629704911
  NPD (past)
• David Allen Steele, DMD

  • General Practice Dentistry
  • Kenilworth, NJ
  • NPI 1679610166
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1700365129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547550090",
            "telephone_number": "715-598-2311",
            "fax_number": "715-350-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BOULEVARD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331637",
            "telephone_number": "908-276-6652",
            "fax_number": "908-709-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONDOVI DENTAL OF NEW JERSEY - BEJARANO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "BRION-MARTIN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "715-598-2311"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maximum Health & Wellness Kenilworth LLC
• Lauren Joy McAlister, ATC
• Courtney McGovern
• Medical Care of New York PC
• Nydia Y Monagas, PSY.D.
• Cristina Monroy-Siddall, LCSW
• Dominick Morabito, RPH REGISTERED PHARM
• Paul Morabito, RPH REGISTERED PHARM
• Moribito RX LLC (Morabito's Pharmacy)
• Myron Medical Imaging, LLC

• General Practice Dentistry in Kenilworth, NJ
• Providers in Kenilworth, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.